What You Need to Know about Endometrial Cancer

Diagnosis

If a woman has symptoms, her doctor asks about her medical history and conducts a physical exam. In addition to checking general signs of health, the doctor usually performs blood and urine tests and one or more of the following procedures:

• The doctor performs a pelvic exam, checking the vagina, uterus, ovaries, bladder, and rectum. The doctor feels these organs for any lumps or changes in their shape or size. An instrument called a speculum is used to widen the vagina so the doctor can see the upper portion of the vagina and the cervix.
• The Pap test is often performed during a pelvic exam. The doctor uses a wooden scraper (spatula) or small brush to collect a sample of cells from the cervix and upper vagina. The cells are then sent to a medical laboratory to be checked for abnormal changes. Because uterine cancer begins inside the uterus, it may not show up on a Pap test, which examines cells from the cervix.
• A biopsy is necessary to help the doctor make a diagnosis. A biopsy can usually be done in the doctor's office. In a biopsy, the doctor removes a sample of tissue from the uterine lining. In some cases, a woman may require a dilation and curettage (D&C), which is usually same-day surgery done in a hospital with anesthesia. During a D&C, the opening of the cervix is widened and the doctor scrapes tissue from the lining of the uterus. A pathologist examines the tissue to check for cancer cells, hyperplasia, or other conditions. After a D&C, women may have cramps and vaginal bleeding during healing.

A woman who needs a biopsy may want to ask the doctor some of the following questions:

• What type of biopsy will I have? Why?
• How long will it take? Will I be awake? Will it hurt?
• How soon will I know the results?
• If I do have cancer, who will talk with me about treatment? When?

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